Systematic review and meta analysis of psychological interventions to prevent or treat pediatric chronic disease in rural communities.
Document Type
Article
Publication Date
7-1-2025
Identifier
DOI: 10.1093/jpepsy/jsae054
Abstract
OBJECTIVE: The purpose of this systematic review and meta-analysis was to examine the effectiveness of psychological interventions at improving physical or mental health outcomes for youth living in rural communities who have, or are at-risk for, any chronic medical condition in comparison to control interventions conducted in rural communities.
METHODS: Following prospective registration (OSF.IO/7TDQJ), 7 databases were searched through July 1, 2023. Studies were included if they were a randomized control trial of a psychological intervention conducted with youth living in a rural area who had, or were at-risk for, a chronic medical condition. Risk of bias was assessed with the Cochrane risk of bias version 2 tool. A qualitative synthesis and meta-analysis were conducted.
RESULTS: 15 studies met inclusion criteria. Obesity studies (n = 13) primarily focused on body mass index metrics, with limited significant findings across studies. Asthma treatment interventions (n = 2) showed no impact on hospitalizations. 3 studies evaluated mental health outcomes with no significant group differences observed. We meta-analytically analyzed 9 studies that evaluated body mass index z-scores and identified an overall null effect (Hedge's g = 0.01, 95% CI [-0.07, 0.09], p = .85).
CONCLUSIONS: Most included studies focused on pediatric obesity, and there was a limited range of health outcomes reported. Compared to controls, minimal significant improvements in health outcomes were identified for psychological interventions for youth living in rural communities. Future efforts may benefit from situating this work more systematically within a health disparities framework with a focus on understanding mechanisms of disparities and translating this work into interventions and policy changes.
Journal Title
Journal of pediatric psychology
Volume
50
Issue
7
First Page
579
Last Page
595
MeSH Keywords
Humans; Chronic Disease; Rural Population; Psychosocial Intervention; Child; Adolescent; Pediatric Obesity
PubMed ID
38981115
Keywords
pediatric psychology; prevention; randomized control trials; rural; treatment
Recommended Citation
Lancaster BD, Hefner T, Leslie-Miller CJ, et al. Systematic review and meta analysis of psychological interventions to prevent or treat pediatric chronic disease in rural communities. J Pediatr Psychol. 2025;50(7):579-595. doi:10.1093/jpepsy/jsae054
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